Faculty Advocate Award Nomination Form

Disability Services for Students

Nominations may originate from the dean or other college administrators, department chairs, program directors, department committees, individual faculty, staff, or students. Self-nominations will not be accepted.

Required materials:

A completed nomination form and one support form is required. Additional support forms are optional and will be accepted if submitted. If nomination and support forms are not fully complete, submissions will not be reviewed by DSS staff.

Deadline for submission: March 22, 2024

Nominee information

Nominee Name (required)

Department

Email (required)

Phone Number (required)

Nominee Affiliation

Is the nominee aware of the nomination?

Yes

Nominee's professional roles and responsibilities (required)

Summarize the nominee's professional role(s) and responsibilities. Describe the nature and length of the nominator's association with the nominee. Please be sure to explain all criteria thoroughly. Minimum 350 words, with a maximum of 500.

Nominator information

Nominator Name (required)

Department (required)

Email (required)

Phone Number (required)

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Disability Services for Students

Faculty Advocate Award Nomination Form

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